Wyoming to Africa: The Workday of a Health Information Specialist

At a remote ranch in the US West, helping Africa share its medical research.

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Thanks to Julia Royall for this guest blog, part of a series about people who work remotely from Dubois.

Before first light, as I am just beginning my day in Wyoming, my colleagues in East Africa are about to end theirs. After a first quick cup of tea, I scurry to respond to email messages. Or I take a quick look in the mirror and make the necessary adjustments to ready myself for a video meeting convened by Ernie, our project assistant based in Seattle. In attendance: Me, in Wyoming, my coworker Becky in Maryland, and our colleagues in Africa.

They are medical librarians in Kenya, Zambia, Zimbabwe, Nigeria, and Mali–part of a network that has developed important projects, from an electronic training manual to a health information center for Masai people in Kenya. Currently, they are creating an African Digital Health Library, an online repository of indigenous research, so that people anywhere who want to know about health care research in Africa can find out what has already been done on location.

My role, for the past 25 years, has been as a facilitator. Starting in 1990 as part of a team enabling some of the sub-Sahara’s first access to the Internet and electronic health information, I have been lifting up African voices by any means possible, to present their scientific findings, their health priorities, and their proposals for new solutions to old scourges — malaria, AIDS, and TB — as well as the chronic diseases of cancer, hypertension, and diabetes.

Today, I’m working with Masimba, a young medical librarian in Zimbabwe whose library features a strong collection. He is working to build a digital repository joining libraries around his country—and even a mobile app—that will allow worldwide sharing of research in Zimbabwe and Ministry of Health reports, priorities, and guidelines.

Of course, my work isn’t all online. Often I travel from Wyoming to Africa. At the Sheraton Hotel in Uganda, when the security guard at the gate leans into my car to ask my driver who I am, Moses says simply, “Figure 1.” The guard lets us through without a word.

I’m not sure how this code got started, but “Figure 1” is the guard code of a security firm in Kampala. It means either “white woman” or “all is well.” That says a lot about privilege, a concept I have struggled with my entire career of working and sometimes living in Africa. No matter how I cut the cake, I am a seemingly wealthy white woman from the West. The term Figure 1 presumes that as a white female, I could probably do no harm or make too many waves. It is a sign of impotent privilege.

I was born and bred on the gentle marshes of Charleston, South Carolina, where I first came to appreciate a transported African culture through the Gullah people of the Lowcountry. I now find myself watching the wide sky from a ranch just outside of Dubois.

My husband’s mother bought properties here over 50 years ago (Spring Ranch, where we live, and Ring Lake Ranch, where she started an ecumenical retreat center), when she left the East forever and became a pastor in an even smaller town nearby. After years of travel and interesting work in research and policy, we too, have left the high-gear life of the East coast to make Dubois our full-time base.

Here, we can watch the badlands turn various shades of red and then fade to silhouette as night begins to fall. Remote rural silent sunsets here in Wyoming are equal in brilliance to those I’ve seen in African countries, but there is a major difference.

Although both sunsets herald the end of day, the nights are different. In Dubois, night is blessedly silent, and usually domed with a cascade of stars.

The night sky in Uganda is also lit, but with the lights of night life in cities or fireflies in the village. The nights in Africa have a sense of urgency and action and possibility.

Africa is not the “dark continent” many still believe it to be (as evidenced by all the fly-by health mission trips and schools of “global health” that have sprung up with development dollars and under-employed graduate students from the US). If we really believed that African countries had potential, we would be supporting their capacity and their own health priorities, sharing all of our glitzy tools, rather than engaging in “development tourism” and neo-colonial research.

From the serene location of Dubois, using the Internet, I will continue to do all I can to help them move their own projects forward.

Julia Royall retired from her position as chief of the Office of International Programs at the US National Institutes of Health’s National Library of Medicine. She continues to work as a health information specialist from Dubois.